优化急救流程在院前腹部脏器损伤致失血性休克中的应用  

Application of optimized first aid procedure in patients with hemorrhagic shock caused by abdominal organ injury

作　　者：陈进[1] 苟君臣 

机构地区：[1]四川省巴中市通江县人民医院麻醉科,636700 [2]四川省江油市骨科医院急诊科,621751

出　　处：《中华灾害救援医学》2016年第7期385-388,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨优化急救流程对院前腹部脏器损伤致失血性休克患者的救治效果。方法以巴中市某人民医院院前腹部外伤致腹腔脏器破裂伴失血性休克患者为研究对象,选取采用传统急救流程救治的34例患者为对照组,采用优化急救流程救治的34例患者为观察组,比较两组患者到达时间、受伤到手术时间、术后失血量、救治成功率、出院生存率、伤残率情况。采用SPSS 19.0统计软件进行统计学处理。结果 (1)观察组出诊半径[(16.32±3.46)vs(15.46±2.21)km]、到达时间[(0.32±0.09)vs(0.23±0.15)h]与对照组比较,差异无统计学意义;观察组受伤到接受手术时间[(0.74±0.13)vs(0.90±0.24)h]、术后失血量[(1846.56±122.50)vs(2035.30±359.73)ml]均低于对照组,两组比较差异具有统计学意义(t=2.656,P=0.017;t=-2.086,P=0.015)。(2)对照组患者抢救成功率为70.59%(24/34),出院生存率为66.66%(16/24);观察组患者抢救成功率为94.12%(32/34),出院生存率为87.50%(28/32),两组患者抢救成功率、出院生存率比较,差异均具有统计学意义(χ2=5.64,P=0.035;χ2=2.05,P=0.028)。(3)对照组存活患者伤残率43.75%(7/16),观察组存活患者伤残率10.71%(3/28),两组存活患者伤残率比较,差异具有统计学意义(P=0.022)。结论优化急救流程能提高患者抢救成功率和出院生存率,减少伤残率,在院前失血性休克患者急救中有积极作用。Objective To study the effect of optimization of first aid procedure on the rescue and treatment of prehospital patients with hemorrhagic shock caused by abdominal organ injury. Methods Patients with hemorrhagic shock caused by abdominal organ injury from a people’s hospital of Bazhong city were selected as research subjects. 34 cases of patients who had used the traditional first aid procedure were selected as the control group, 34 cases of patients who had used optimized first aid procedure were selected as the experimental group. By analyzing the clinical data and treatment situation of patients, and the arrival time, time from injury to the operation, postoperative blood loss, treatment success rate, discharge survival rate, disability rate were compared between the two groups. SPSS 19.0 was applied for the statistic analysis. Results （1）The radii of visits [（16.32±3.46） vs（15.46±2.21） km] and time of arrival [（0.32±0.09） vs（ 0.23±0.15） h] in observation group have no significant difference compared with control group; time from being injured to accepting operation [（0.74±0.13） vs（0.90±0.24） h] and postoperative blood loss [（1846.56±122.50） vs （2035.30±359.73） ml] of observation group were significantly lower than those of the control group, and the differences were statistically significant （t=2.656,P=0.017;t=-2.086, P=0.015）. （2）Rescue success rate of the control group was 70.59% （24/34）, and that of observation group was 94.12% （32/34）. Discharge survival rate of the control group was 66.66% （16/24）, and that of the observation group was 87.50% （28/32）. There were significant differences in rescue success rate and discharge survival rate between two groups （χ 2=5.64, P=0.035; χ 2=2.05, P=0.028）.（3）Disability rate of the control group was 43.75% （7/16）, and that of observation group was 10.71% （3/28）, therefore there was a significant difference in disability rate between two groups （P=0.022）. Conclusions Optimizatio

关 键 词：腹腔 破裂 失血性休克 

分 类 号：R459.7[医药卫生—急诊医学]